Individual provider Active NPI

Brian M Mathie, O.D.

  • Optometrist
  • Canton, OH
National Provider Identifier
1013953116
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
4213 Issued in OH
Practice address
5890 Mayfair Rd
Canton, OH 44720-1547
Phone
(330) 305-2200
Fax
(330) 305-2210
NPI assigned
Jun 20, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 4213 OH Primary

Addresses

Primary practice location

5890 Mayfair Rd
Canton, OH 44720-1547

Mailing address

5890 Mayfair Rd
Canton, OH 44720-1547
Phone (330) 305-2200

Other identifiers 5

IdentifierTypeStateIssuer
000000203490OtherANTHEM
0844779MedicaidOH
4384872OtherOHAETNA
1404675OtherUNITED HEALTH CARE
001301628OtherKEYSTONE HEALTH/HIGHMARK

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090715000234 OH Practitioner - Optometry 9234281783 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Ohio State University - College of Optometry, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Roholt Vision Institute IncGroup PAC ID 0143204388, 6 clinicians

Practice addresses (Care Compare)

1207 W State St
Alliance, OH 44601-4686
Phone (330) 829-2311

25 Manor Hill Dr
Canfield, OH 44406-1596
Phone (330) 702-8755

5890 Mayfair Rd
North Canton, OH 44720-1547
Phone (330) 305-2200

Merit-based Incentive Payment System (MIPS)

Final score
87.76 of 100Reported as group
Quality
100
Improvement activities
40
Cost
59.2

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4213OHMDPhysical Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Roholt Vision Instititute Inc Current Accepting new patients
Roholt Vision Institute Inc CurrentSince May 11, 2009 Accepting new patients
Roholt Vision Institute Inc CurrentSince May 11, 2009 Accepting new patients
Independent Lab Services Past Accepting new patients

Locations

1207 W State St
Alliance, OH 44601
Phone (330) 451-1310

25 Manor Hill Dr
Canfield, OH 44406
Phone (330) 702-8755

5890 Mayfair Rd
Green, OH 44720
Phone (330) 305-2200

Interoperability endpoints

  • Direct secure messaging: bmathie@roholt.intellechartdirect.net

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1150761600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1013953116",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5890 MAYFAIR RD",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447201547",
            "telephone_number": "330-305-2200",
            "fax_number": "330-305-2210"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5890 MAYFAIR RD",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447201547",
            "telephone_number": "330-305-2200",
            "fax_number": "330-305-2210"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATHIE",
        "first_name": "BRIAN",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OH",
            "license": "4213",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000203490",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0844779",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "4384872",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTH CARE",
            "identifier": "1404675",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KEYSTONE HEALTH/HIGHMARK",
            "identifier": "001301628",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Canton, OH

Sources for this page

Verify at the official NPI Registry.